RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00642
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Police, medically separated for “right ankle pain” with a disability rating of 10%.  

CI CONTENTION:  Review all conditions.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board (MEB), but determined by the PEB to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for the unfitting medical condition(s) at the time of separation.  The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions; that role and authority is granted by Congress to the Department of Veterans Affairs, which operates under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20060602	VARD - 20061227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain and Instability	5099-5003	10%	Residuals of Right Distal Fibular Fracture, Postoperative	5271-5262	10%	20061004	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Right Ankle Pain and Instability.  According to the service treatment record and MEB narrative summary (NARSUM), the CI suffered a right ankle avulsion fracture prior to service in 2004 and underwent surgery.  She had the hardware removed to qualify for military service.  She was treated with casting and physical therapy but continued to have frequent giving way and pain.  X-rays showed arthritic changes, calcification at the tibiofibular ligament and a very small avulsion of the inner aspect of the lateral malleolus.  Surgical reconstruction/stabilization surgery was considered but not conducted for generalized ligamentous laxity.  

During the 25 April 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported chronic right ankle pain.  Physical examination showed crepitus, but no tenderness or swelling.  The range of motion (ROM) evaluation showed full ROM with audible popping.  

The 10 May 2006 MEB NARSUM examination, 1 month prior to separation, showed right ankle tenderness and slight lateral ligament instability (slight talar tilt).  Ankle ROM was dorsiflexion to 30 degrees (normal 20) and plantar flexion to 60 degrees (normal 45).  There was no swelling, crepitus or anterior instability.   

At the 4 October 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported aching right ankle pain two or three times per week.  The CI was able to walk 2 miles per day, 3 times per week.  Physical examination showed a normal gait with mild tenderness at the lateral right ankle.  Right ankle ROM was dorsiflexion to 20 degrees and plantar flexion to 45 degrees.  There was no instability or weakness.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, analogously coded 5003 (arthritis, degenerative), citing slight and constant ankle pain IAW the US Army Physical Disability Agency pain policy.  The VA also rated the right ankle condition 10%, coded 5271-5262 (ankle limitation of motion-tibia and fibula, impairment of: malunion), based on the C&P examination, citing malunion of the tibia and fibula with slight ankle disability.  

There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a 10% rating under 5271.  There was no nonunion or malunion of the tibia to support consideration under the ankle disability code (5262).  No additional functional limitation was evidenced by the examinations.  Therefore, the panel concluded there was not sufficient evidence to support a rating higher than the 10% adjudicated by the PEB.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right ankle condition.  

BOARD FINDINGS:  In the matter of the right ankle condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

AR20180012970, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear  XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.